JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 53 No. 12                   2007

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Recently, improved techniques for angiography have enabled a catheter to be superselectively placed from the superficial temporal artery to the feeding artery of oral cancer. Superselective intra-arterial infusion can limit the infusion area of anticancer agents as compared with selective intra-arterial injection. High concentrations of anticancer agents around a tumor can more effectively control lesions at the same dosage. Thus, we tried a new technique for superselective intra-arterial infusion with arterial redistribution to the facial artery. Our new technique was as follows. The superficial temporal artery was exposed surgically, and a sheath was inserted. A guide wire and apical bent catheter were inserted in a branch of the facial artery, using digital subtraction angiography as previously described. A micro-catheter was inserted through an apical bent catheter, and embolization of the facial artery with micro-coils was performed at the periphery of the tumor. Finally another catheter coated with heparin was placed in the facial artery. We used this technique to treat a case of carcinoma arising in the buccal mucosa (T3NOMO). Chemotherapy with intra-arterial infusion (5-FU 100-30 mg/m2/day, TXT 15 mg/m2 week) combined with radiation therapy (total 40 Gy) was given for 4 weeks after surgery. The clinical effect was complete response (CR). Embolization of an ascending branch of the facial artery leads to hemodynamic changes and facilitales the delivery of anticancer agents to the target region with minimal adverse events. Key words: superselective intra-arterial infusion, arterial redistribution, facial artery

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